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4 –
Daily Update
– DAY TWO – Tuesday 27 April 2010
SPENDING ON HARM REDUCTION
needs to
be increased ‘urgently and dramatically’, accord-
ing to a major new IHRA report launched at the
conference yesterday. A ‘cautious estimate’ of the
amount invested in HIV-related harm reduction in
low- and middle-income countries in 2007 is
approximately $160m, equating to $12.80 per
injector per year, or three US cents per day, says
Three cents a day is not enough
– resourcing HIV-
related harm reduction on a global basis.
Furthermore, states the report, this is ‘almost
certainly’ an overestimate of actual spending.
UNAIDS estimates the resources needed for
harm reduction for 2010 at $3.2bn, or $256 per
injector per year, figures which do not take into
account additional resources for antiretroviral
therapy, care and support, the report stresses.
‘Current spending is clearly only a small
proportion of that required and is nowhere near
proportionate to need,’ it says.
Global funding for harm reduction is provided
by ‘a handful’ of donor countries, the document
continues – 90 per cent of the $160m for 2007
($136m) came from donor contributions, while
most major international philanthropic donors
remain conspicuous by their absence from harm
reduction funding. The report calls for more high-
income countries to get involved in funding harm
reduction if progress towards the goal of
universal access to HIV prevention programmes
– something the UN is committed to – is to be
achieved for injecting drug users.
Donors should be able to set targets for the
proportion of global spending going to HIV-
related harm reduction, the report recommends,
and IHRA wants to see this global spend properly
monitored by UNAIDS and NGOs. Resources for
harm reduction and HIV services for drug users
should be proportionate to need within countries,
it states, and a global community fund for harm
reduction should be established to advocate for
increased resources. The report also concludes
that, given the scale of the funding gap, ‘new
ways of delivering harm reduction services’ may
be necessary.
‘Rather than coming close to ensuring
universal access, the current funding represents
about one-twentieth of what is required,’ states
the document. ‘People who use drugs are not
receiving the harm reduction services that they
need and to which they have a right. At current
rates of progress, universal access to HIV
prevention for people who inject drugs will not be
achieved for decades, let alone in 2010. The
scale of investment in harm reduction needs to
be quickly and radically increased.’
Three cents a day is not enough, by Gerry V
Stimson, Catherine Cook, Jamie Bridge, Javier
Rio-Navarro, Rick Lines and Damon Barrett,
available from www.ihra.net
Urgent increase needed in harm reduction funding, says IHRA report
Three cents a day – the value of a life
EUROPE HAD BEEN A CHAMPION
for harm
reduction and the catalyst for models of harm
reduction that had since gone on to be adopted
around the world as best practice, Mat
Southwell of INPUD told delegates in the
Harm
reduction in Europe
session. The challenge was to
scale that up around the world, he said.
‘It cannot be right that in Europe we can
have life-saving strategies to protect people
who use drugs, while in Russia there are
thousands of heroin-related deaths every year’.
In the fierce debates at places such as the
Commission on Narcotic Drugs, the EU was
central to fighting harm reduction’s corner,
such as when 26 countries under the
leadership of Germany stated that HIV
prevention meant harm reduction. ‘It’s
important that we see the increasing
discomfort in what’s called the “unintended
consequences” of drug control,’ he said.
Harm reduction’s move to the mainstream
did not mean there was not still substantial
reticence – while people may accept many of the
core harm reduction functions, they could
remain ambivalent about things such as
consumption rooms, heroin prescribing and
crack pipe distribution. ‘The evidence of harm
reduction is overwhelming,’ he said. ‘It’s dogma
that prevents us from implementing it.’
The conference would also see the launch of
the European Harm Reduction Network,
following the approval of EU funding last year, he
said. The network would be driven by science
and would share best practice and learning as
well as encourage members to challenge each
other. Open to individuals and organisations, the
network would be supported and coordinated by
IHRA, and would have three subregional
networks – Northern Europe, Central and
Eastern Europe and Southern Europe.
It was essential to spread the real progress
that had been made in countries like Spain and
Portugal all over the world, as well as to defend
harm reduction in those parts of Europe where
people were trying to row back. ‘As we start to
win the arguments on the ground, people will
start to co-opt our arguments,’ he said. ‘We must
learn to resist that.
‘No longer are we the subject of a network –
you trying to help and cure us,’ he continued.
‘We’re sitting at the table as equal partners. This
allows us to advocate more strongly and clearly
with the EU and governments for harm
reduction.’ It was also essential that harm
reduction did not stand still as drug use was
continuing to change, he said, and vital that
there was active empowerment to ensure
meaningful input of people who use drugs.
Drug users nowequal
partners in harm reduction
Mat Southwell:
‘It cannot be right that in Europe
we can have life-saving strategies to protect
people who use drugs, while in Russia there are
thousands of heroin-related deaths every year’